Category Archives: Aging & Community

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Even though the heat of late August for the most part continues, you can hear it, some still say – “Summer is on the wane.” But let’s not get morose. September month is one of the most beautiful of this season. Neither is it time to give up on our Planet Longevity call for celebrating a Senior’s Summer. We opened with our suggested theme “Inter-generational Opportunities: Things that Bond Us” and hopefully that’s what we explored in all our conversations.

As Suzanne Cook said in her June 30th blog post Top Five Spaces and Places for Inter-generational Relationships, we need to “encourage and cultivate non-familial inter-generational interactions.” Traveling through a few small towns and cities in Ontario over the summer, I certainly easily observed evidence that familial interactions were alive and well, but not so obvious was the non-familial. They are there, but you have to dig for them.

Looking forward to 2016, perhaps the Ontario Seniors’ Secretariat can generate a more dynamic interest by adopting this inter-generational theme as I suggested in my June 18 post on creating inter-generational narrative. One key way to strengthen this is to, in some way link the conversations to the Age-Friendly community initiative.

What does it take?

Why not reach out to high schools and colleges such as Sheridan College, which has an Elder Research Centre, where seniors could actively approach student groups to develop a forum, or even run a contest for the best ideas to discuss ways we can build “vibrant inter-generational communities”.

Perhaps this is a sponsorship opportunity for any business with a service or product they are targeting to an older demographic segment, where the primary person helping to make the buying decision is actually from a younger age group. In fact, some community Councils on Aging are tagging to the Age-Friendly theme, or are designated within the World Health Organization (WHO) global Age-Friendly World movement.

The Toronto Council on Aging talks to plans for neighborhood projects that include interaction with Business Improvement Areas (BIA’s). These BIA’s in turn could involve the school systems in contests or “inter-generational forums” as suggested above. Neighbourhood networks promoting Age-Friendly initiatives must include younger people.

Seniors – Go Big!

So for next year, if Ontario Seniors groups want to pick up more vibrancy from 2015, begin now to make it a Seniors’ Summer with outward facing messaging that encourages the benefits of an inter-generational exchange of ideas. Go big!

In what ways can all generations engage and participate in a conversation and dialogue about greater longevity and a vibrant later life? An excellent start is to foster inter-generational relationships with intent, harness the power of inter-generational bonds and interactions, something that is largely untapped. Research indicates that these as perspectives, experiences and interactions are not commonly engaged in either direction – older to younger or younger to older.

One part of the Age Friendly Communities initiative needs to be to encourage and cultivate non-familial inter-generational interactions. Where are the best places to seek out inter-generational interactions?

Here are the five top places and spaces for inter-generational connections to thrive. These are through:

• volunteer and service work, as individuals from different generations contribute their time to the same cause or issue in the community

• the workplace, where individuals from different generations work, converse and solve problems together

• associations with neighbours when interacting with people living in the neighbourhood

• the broader community where individuals meet and speak with others as they engage in daily activities and daily interactions, living their lives; and

• learning and educational institutions, especially as inter-generational learning becomes more prevalent such as in the Sociology of Aging course I taught at York University

If the generations engage more readily in these five top places then the trigger questions for success are – how can dialogue and conversations be encouraged on meaningful issues of mutual concern? How can outward facing messages be stimulated that engage all ages in conversation, so that everyone benefits?

The top tip for strengthening inter-generational interactions is to encourage good listening skills. In this way, each individual will hear better across generations. Everyone is valued and respected. This is an excellent beginning and an excellent way to develop better inter-generational relationships.

In our post May 22nd, we at Planet Longevity promoted a broader view on the celebration of Seniors’ Month in Ontario; our contribution, the theme “Inter-generational Opportunities: Things that Bond Us”. In fact, we said – why not make it a Seniors’ Summer?

The 2015 Ontario Seniors Secretariat Vibrant Seniors, Vibrant Communities theme at first glance suggests that we should all recognize, that if our senior population is vibrantly engaged, then the whole community benefits. This is true. As the Seniors Secretariat web site says: “We recognize the spirit of seniors . . . and encourage all Ontarians to participate in Seniors’ Month.”

Yet if you take a look at the various Ontario community Seniors’ Month event calendars published online; the activities, programs and information sessions on offer tend to speak directly to the core audience – Seniors. Seniors celebrating Seniors is a good thing. But you might be hard pressed to find much in the calendar listings and supporting visuals that suggests that this month invites any inter-generational interest or participation. At least not by immediate inference.

The Toronto Community Housing web site has a basic Seniors’ Month page with a link there to a group called Toronto Intergenerational Partnerships (TIGP) however the Upcoming Events page seems inactive at last check. TorontoCentralhealthline.caposted a recent article by the folks at Mosaic Home Care which points in one paragraph to the importance . . .

“for all of us, seniors included to think of how we as a community can increase our interaction and our understanding of each other. Institutions, businesses, and individuals all have a role to play.”

This is the right message and maybe by the next time we get around to Seniors’ Month 2016 we’ll find a way to put out more firmly worded, outward facing messaging that encourages the benefits of an inter-generational exchange of ideas. If current younger generations are going to experience an even greater longevity, then the question could be; how do you make a conversation about the experience of a vibrant later life in a vibrant community relevant to them today?

That’s why we need more runway for this celebration – as we suggest a Seniors’ Summer. More time to create an inter-generational narrative.

With spring finally here, what a great time to announce that I was the first guest on the new weekly show called Why Our Seniors Matter launched May 4th, 2015 on ListenUp Talk Radio where my interview focused on a holistic approach to healthy aging. While this show will cover a range of topics of broad interest in the daily lives of seniors, it seems perfectly fitting to open with this holistic view.

Over the next thirteen weeks, the Why Our Seniors Matter show will feature many practical matters from finance to fitness, but they all tie in to one or more of the eight aspects of the holistic healthy aging – social, cognitive, physical, psychological, spiritual, purposeful work, financial and environmental.

In my progress, through my work as a gerontologist and educator, my focus has been on supporting a new vison of aging – healthy aging that is not only out of concern for the old but also for their families which makes all this truly an “inter-generational” new vision.

As I mentioned in the Talk Radio interview, there are gaps in how we provide information on aging matters directly to seniors in the community, and there will be a growing demand on family members of all ages to become an integral part of that information food chain as the aging demographic curve rises over the next two decades.

Furthermore, we require new ways of providing information and resources to those who need it. Communities and municipalities as well as businesses serving seniors can do a lot to shape the way information about seniors’ services and resources is presented. Lack of awareness is one issue but equally important is timely information provision.

Many older adults have complex needs and the best way to meet them is to enhance information, including knowledge of resources and tools. Better information provision is a key way to build an age-friendly society.

Coming up in June is Seniors’ Month in Ontario. Listening in to the Why Our Seniors Matter radio show is timely and as it happens all this coincides with our Planet Longevity theme of inter-generational connections as part of what makes a healthier age friendly community; all viewed in that holistic approach.
Suzanne Cook

What is a family? How could our concept of what a family is, or might be, impact our choices in living healthily? Might we have both a blood-related and a strong chosen family? In what way might we create a sense of family that serves the needs all generations? What implications might that have for chapters in our later life?

I recently met several women who met in their twenties, and over the past forty years have created and lived the benefits of a strong chosen “family”. Some formed committed relationships and adopted or bore children and some remained single.

Here are ways that a broad definition of “family” has served them. As you read the list, consider the ways these could be beneficial. You or someone you know:

• owns a time-share and regularly includes others in vacations
• has a large garden for outdoor parties and growing vegetables to share
• maintains (although single), a large vehicle that can accommodate the “family” including providing transit when one of the younger generation went off to university or if mobility devices need to be transported
• shares their electric car for short journeys
• includes someone without children/grandchildren of their own in family events, celebrations, discussions of decisions on health and education

These women have taken vacations together to defer cost and share in the experience. They regularly cook large quantities of food and share in the preparation or meals and social interaction with others lives. All have chosen to live in close enough proximity to participate in caregiving if someone is ill, and for social interaction.

There are practical and sometimes legal issues to be considered, when we intertwine our lives in this way but many models of “family” are increasingly being explored.

How is this relevant for you? In what way could you explore the opportunities you might embrace by broadening your “family”? What benefits or challenges would you anticipate? Who makes up your family? Where do the opportunities lie for you?

Likely, your longevity – your life course will be more positively shaped by how innovative you are in answering these questions.

In 2007, the World Health Organization (WHO) published a Global Age-friendly Cities Guide. Born out of a conversation at the World Congress of Gerontology and Geriatrics in Brazil two years earlier, it quickly became an international project with a huge scope. Let me proudly mention here, that there was a unique Canadian contribution early in this endeavour with funding and in-kind support from the Public Health Agency of Canada. You can read the rest of the tribute in the WHO guide.

The WHO “age-friendly” concept describes itself around eight themes and with the subset issues considered what you get is a combination of 70 elements and woven together it is enough to serve as a platform for robust discussion for innovation and change. As a group at Planet Longevity, our intent is to support this discussion across all generations.

Four cities in Canada (Halifax, Portage La Prairie, Sherbrooke and Saanich) took part in the initial 33-city WHO research project and since then a number of Canadian cities have formed community initiatives around this theme. From what I can tell, over the eight years since then, participation has been fragmented, and to some degree the conversation seems rather muted if non-existent in the general population. I think the perception is that “age-friendly” is an older person’s bone to chew on.

Why is this still significant for everyone? It’s no mystery that by 2030 the global population will be at the highest level of its migration to cities. In fact, we are realizing the impact of this right now. The evolution of cities will be every generation’s project – function, form, flow and the fabric of human interaction. Over the next fifteen years, the percentage of persons older than 65 will be significantly higher and thus the need to adapt the urban agenda to a workable inter-generational model for an aging population is a key opportunity.

A new narrative must frame how cities can be better designed, while integrating specific incremental life stage needs of older people alongside the shared needs of all generations – remembering that positive social interaction is a major contributor to the healthier lives of all generations.

Perhaps, could the better phrase be – “age-inclusive” cities?

_______ ♦_______

One element of societal change related to aging demographics in cities is the shifting nature of families and the evolution of other networks and communities. Considering we age in stages throughout a lifetime, (and today in more variable social formations), we might see it as evolutionary that there are life course solutions that more than one generation can envision.

Next month Lorraine Clemes will talk about one group of women as an example, who for the last forty years have “created and lived the benefits of a strong chosen family”.

Solutions to the issue of elder care, whether as part of “community home care” or the broader matter of frail, ill elders needing institutional care, are part of the need to consider radical changes to our health care system in general. The Commonwealth Institute think-tank, ranks Canada dead last amongst the 11 top advanced nations in terms of timely health care access by its citizens. Timely acute care access is lacking, and so is access to long-term care.

Part of the solution lies in creating new funding models for Canadian health care: systems that have already proven successful in the other 10 leading health care jurisdictions. All have a mix of public and private funding and facilities.
Some possible means of changing Canada’s “government as gatekeeper/payer” system include the following ideas:

• Phase out “pay as you go” funding (payments from current general government revenues) and replace it with revenue generated from an investment or insurance entity modeled on the Canada Pension Plan Investment Board. The smaller number of taxpayers in the future will not be able to pay for health and other services for the looming bulge of aging Boomers if the current funding method remains.

• Bring back tax incentives such as the Multiple Unit Residential Building program (MURB). Target the construction of universal access, single or multiple family residences, and long-term/chronic care residential/medical facilities, which would reduce the pressure on acute care hospitals currently warehousing patients who cannot live at home.

• Adapt ideas from the successful systems of the nine other countries with better health care outcomes. Start a meaningful discussion of alternatives. Begin by discounting the “straw man” argument that any discussion of change in Canadian Medicare means “American health care”. No one proposes American health care.

• Consider introducing “medical savings accounts” for all Canadians. It would be a voucher system where each Canadian can spend on either public OR private health care services. Special funding would be provided for chronic or exceptional cases. This was first proposed in 2002, in a paper presented by the Fraser Institute.

• Ensure that publicly funded health care programs have elements of self-funding. Require that the means test for government payments includes the value of assets not just cash flow. Many people have substantial assets that could be used to pay for services they need – yet they can access subsidies because they have low cash flow, currently the main criteria for assistance.

• Channel more medical students into specialties such as geriatrics and areas related to caring for aging Canadians. It costs over $1 million to educate a doctor in Canada. Surely, it is reasonable to expect medical practitioners to work in critical fields. There is also a shortage of medical technicians. Incentives are needed to boost their numbers, too.

• Encourage philanthropic investments in communities across Canada through special charitable donation credits for the construction and maintenance of senior and disabled-friendly residences and care facilities. Palliative care centres need to be part of this initiative. Many religious and ethnic communities have already begun providing these facilities. As a corollary, beef up the health and safety inspection of residences for seniors in care, and make penalties meaningful.

• In Norway, local municipalities are responsible for getting patients out of acute care hospitals and into innovative, long-term care facilities. Daily fines for non-compliance help focus administrators on achieving results. (Local municipalities do receive increased funding for their role in these services.) Canada and its provinces could learn from this.

Are these revolutionary ideas? Yes, but the need for discussion is urgent.

The stage was set in my Jan.30th blog. Community home care has four factors to consider – Medical and Accommodation as outlined, and now Demographics and Funding.

Demographics. By 2031, the estimation is that the proportion of seniors 65+ in the Canadian population will be at 23%, up from 17.3% currently. (Around then, deaths will outnumber births in Canada.) If our total population reaches the projected 40 million, that would make the 65+ population about 9.2 million. These demographic statistics form a base for figuring out what various social needs are likely to be for an aging population including community home care.

Funding. The Baby Boom generation, now retiring, is the wealthiest generation in history. Bank of Montreal economist Sal Guatieri said in The National Post July 19, 2014; that “the typical senior today is 9 times richer than the typical Millennial”. Boomers are also the generation that expects to get what it wants.

Currently, given that the number of working Canadians is declining, it is unlikely that the Boomers’ demands can be met as expected. Statistics Canada states that by 2031, the number of people in the labour market for each person aged 65+ (not working), could be lower than three. This ratio was close to 5 to 1 in 2010.

The key question is – what level of responsibility must the individual assume for their living and care arrangements? And what is the responsibility of the community or governments? Who will pay for these obligations? Can we mobilize popular support for community-based programs, or must we rely on governments for action?

Canada’s current approach to funding such programs (and many pensions, too) is “pay as you go”. This means that payments for these services are taken from current general tax revenues. If there are fewer active workers than those over 65 not working, how can we expect that programs benefiting mainly seniors will be acceptable to working taxpayers, who will want some funding room for their children’s education and family health care?

In an era of tight budgets and a future with fewer taxpayers contributing to government programs, “universality” is a problem. The Canada Pension Plan was changed from “pay as you go” to fully funded with contributions by workers who expect to benefit in the future. With pay as you go, the Boomers have no “skin in the game”. The burden is on younger taxpayer – and with a smaller number of workers/taxpayers there is enormous potential for inter-generational conflict of interests.

So far, the clamour for community home care is too broad and unfocused. I’ll set some talking points for solutions for the next post – a more refined and targeted discussion, given scarce resources now and in the future.

Community home care for an aging demographic; what does it mean? The term “community home care” s bandied about as though it has a specific meaning and that we should all know what it is – but it can mean:

Aging in place: remaining in your own traditional home, supported by housekeeping and healthcare services, until you are no longer able to cope

Purpose built or adapted housing residences: for those who want to be part of a “community” of people that might be comprised only of older seniors, or a mixture of people of various ages, as in a neighbourhood, with housekeeping and healthcare services available.

Care residences: where older seniors are the main residents because they require dedicated care provided by community members, volunteers and professionals; paid for by residents or by government, non-profit or charitable organizations or a combination of these. This is where Long Term Care facilities enter the discussion.

Essentially, there are four major factors to consider in this mix: Medical, Accommodation (housing), Demographics and Funding. Here are the first two.

Medical. There are risks to the “aging in place” model. Many older seniors become trapped in the “tea and toast” syndrome wherein they do not eat properly or take care of themselves physically and mentally. Loneliness and depression and physical injuries, which may be undiscovered for hours or days, can occur.

Accommodation. Moving to a smaller home, whether purpose-built or in the broader neighbourhood can be a daunting prospect. Most people rightly dread moving, with its stress and upheaval. Sometimes, too, family members pressure their elders into staying put since the home is “the family home” and repository of happy memories (and increased, non-taxable capital gains over time.) In terms of their housing, many older seniors are house rich but cash-flow poor.

Hope and reality on a collision course? Should government direct scarce resources into caring for seniors in need at home when the logical solution is for them to sell their valuable house and downsize, and then use the surplus to pay for the help they need?

This sets context for the next blog post on demographics and funding. In brief, Boomers looking forward should consider their assets owned as well as their income streams; as their hope and reality for community home care for themselves may be on a collision course.

Age awareness has meaning to everyone at every life-stage, so by leading a charge advocating for community home care for older adults the question is; how are we serving our community if we don’t bring a broader range of insights to the issue? After reading Carol Goar’s Dec.9 Toronto Star article “Senior citizens are mobilizing against ageism”, it occurred to me that we need doable solutions that everyone can share in.

In my work with Big Brothers Big Sisters of Toronto over the years, I’ve always been drawn to their ‘strength based’ approach to mentoring. Simply put, volunteer mentors are trained to allow the child to be who they are without ‘fixing’ them or trying to make them ‘better’. It’s about accepting them ‘as is’ and building their self-confidence. This in turn allows them to be equipped with a toolbox of life skills that (as studies confirm), serve them as they mature.

Likewise, the conversation on confronting ageism raised by organizations like Carewatch needs to be strength based. What are the skills that all segments of the population (from Gen X, to Millennials, to Boomers) bring to the table, and how can we take each groups strengths to assist those who need help. What if we made care of seniors who wish to remain in their home a community issue, not just a family or government issue?

Let’s look at ageism through a different lens by examining an inter-generational approach which would allow learning and support at all ages. If we looked at community home care as a way to build a foundation for a caring community – we would all bebetter together. And it’s not just about health care delivery. There are other basic living and social needs to be served with more of what we might call an “age share model”.

For example, how about having a high school student earning community hours by teaching a housebound senior computer applications that could open a new world to them? Cyber-Seniors is an example.

What if a local apartment/condo dweller who loved to garden was matched with an older homeowner who was unable to tend to their garden, and took on the task of planting and tending a vegetable or flower garden in their yard? Tyze is an example of one of those doable solutions; an inter-generational social network.

So literally – let’s look in our own backyards to find other workable options for advocating qualitycommunitycare.